Provider Demographics
NPI:1326271701
Name:MAHABIR, RENITA NADINA (PHARMD)
Entity Type:Individual
Prefix:
First Name:RENITA
Middle Name:NADINA
Last Name:MAHABIR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 LONG DR
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4708
Mailing Address - Country:US
Mailing Address - Phone:917-763-1241
Mailing Address - Fax:
Practice Address - Street 1:200 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5510
Practice Address - Country:US
Practice Address - Phone:516-414-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist